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Educational Equity in Obstetric Training: Procedural Disparities in the Ob/Gyn Clerkship
Melissa R Rosen1, Brooke E Schroeder2, Katherine A Lambert3
1Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Objective:
To assess for differences in obstetric procedural experiences on the obstetrics and gynecology (OB/GYN) clerkship based on medical student race and gender.
Design:
IRB-approved retrospective cohort study of medical student case logs on their OB/GYN clerkship between 2014 and 2022.
Setting:
Single United States allopathic medical school, with clinical rotations at a tertiary care center-Duke University School of Medicine, Durham, North Carolina PARTICIPANTS: 918 medical students who completed their OB/GYN clerkship between 2014 and 2022. Students with missing race or gender data from the information shared by the Assistant Dean of Education were excluded, resulting in a total of 869 students included in the analysis.
Results:
Among 869 students included in the study, 59.0% were female and 23.9% identified as underrepresented minorities in medicine (URM). There were no significant differences in "hands-on" experience in vaginal or cesarean deliveries based on medical student race or gender. However, URM male students participated in 0.74 fewer vaginal deliveries (95% CI: -1.35 to -0.12) and 1 less total delivery (95% CI: -1.91 to -0.07) than non-URM female students, while non-URM male students participated in 0.45 fewer vaginal deliveries (95% CI: -0.87 to -0.03) than non-URM female peers. These results were obtained while controlling for differences based on academic year and clerkship timing within the academic year.
Conclusions:
No differences were noted in "hands-on" delivery experience during the OB/GYN clerkship based on medical student gender or URM status, however subgroup analyses revealed that URM and non-URM male students participated in fewer vaginal deliveries compared to non-URM female peers. These differences, although modest, highlight potential disparities in clinical exposure and inclusion in the learning environment, warranting further investigation and underscoring the need for continued efforts to ensure equitable learning opportunities for all students.
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